These are in general much lower risk than bite exposure and rarely cause rabies. Doctor answers on symptoms, diagnosis, treatment, and more. Rabies environmental health and safety virginia tech. Occasionally reports of non bite exposure are such that postexposure prophylaxis is given. Finally, airborne, non bite transmission has occurred in a bat cave and in laboratories where the rabies virus was being handled. All bites, regardless of body site, represent a potential risk of rabies transmission, but that risk varies with the species of biting animal, the anatomic site of the bite, and the severity of the wound. Six fatal cases of classical rabies virus without biting. Management of possible rabies exposures in humans, animal bites and rabies risk questions about possible rabies exposure, consultations on animal bites and rabies risk, evaluation of the patient following animal bites, assessment of the need for rabies post exposure prophylaxis, human rabies risk evaluation. Bite and nonbite exposures from an infected person could theoretically transmit rabies, but no such cases have been documented. Rabies cannot be spread through casual contact, such as touching a person with the disease, or contact with noninfectious fluid or tissue. Most cases of dog and cat rabies occur in areas where they are more likely to come into contact with wildlife. Since 1981, in the united states, there are more documented cases of rabies in cats than in dogs.
Rabies bite manual alabama department of public health. Thus, the limited data on risk has led to the frequent administration of rabies post exposure prophylaxis pep, often in inappropriate circumstances. Another question is, how can you get the post exposure shots if doctors dont think you need them. Early symptoms can include fever and tingling at the site of exposure.
Clinical and epidemiological features of human rabies cases. Rabies through non bite exposure tips and tricks from. Species of the biting animal, guidelines for managing animal bites and bat encounters. Anyone with a potential rabies exposure should seek medical care. The vast majority of cases of rabies are transmitted through the bite of a rabid animal. However, rabies pep was overwhelmingly not recommended for nonbite exposures e. Rabies prevention involves two main, nonexclusive strategies. Jun 21, 2019 quiambao bp, ambas c, diego s, bosch castells v, korejwo j, petit c, et al. When a person reports an encounter with a bat or other animal, public health authorities assess the rabies risk and may provide rabies postexposure prophylaxis to prevent infection. These symptoms are followed by one or more of the following symptoms. A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Rabies pep is considered safe and 100% effective in preventing human rabies following an exposure when administered according to recommendations from cdcs advisory committee for immunization. Approximately 6,000 to 7,000 cases of animal rabies are reported each.
In other words, they do not have enough time to bite and infect a human. The large number of rabies infected cats might be attributed to fewer cat vaccination laws, fewer leash laws, and the roaming habits of cats. Pdf human rabies post exposure prophylaxis in bhutan, 2005. We used the delphi method to obtain an expert group consensus estimate of. Scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or other potentially infectious material such as brain tissue from a rabid animal constitute non bite exposures. Report any animal bite exposures to the livingston county animal control 517 5462154, monday through friday, 8 a. Animal bites, nonbite exposure, or humantohuman exposure are all ways in which rabies can be transmitted. Rabies is a disease that affects the nervous system of humans and other mammals. New jersey report of rabies postexposure treatment form. In developing countries, most rabies cases in humans are caused by dog bites. The new jersey report of rabies postexposure treatment app is a report form for a health care provider to communicate the treatment of patients with cases of rabies to the local health department. Is the dog still well two weeks after contact with you. In the united states, the risk of rabies transmission to humans in most situations of possible exposure is unknown.
Estimating the risk of rabies transmission to humans in the u. Management of potential rabies exposures guideline. Rabies non bite case studies doctor answers on healthcaremagic. Management of animals other than dogs, cats, and ferrets depends on the species, the circumstances of the bite, the epidemiology of rabies in the area, the biting animals history, current health status, and the animals potential for exposure to rabies. In many developing countries, dogs are the major vector of rabies. Human animal bites are not a reportable condition in bhutan, but bite victims. Jun 24, 2012 overall, these nonbite associated cases account for a small minority of human rabies cases that occur every year, but unusual routes of exposure need to be considered in any case. Four of the nonbite exposures had no recognized exposure whatsoever 0.
Overall, these nonbite associated cases account for a small minority of human rabies cases that occur every year, but unusual routes of exposure need to be considered in any case. And while the only reported cases of humantohuman transmission have occurred as a result of corneal implants from infected donors, bite or nonbite exposures inflicted by infected persons could theoretically transmit rabies, too. Rabies is not transmitted by contact with blood, urine or feces, by touching fur, or by skunk spray. Clinical and epidemiological features of human rabies.
Scratches, abrasions, open wounds, and mucous membranes contaminated with saliva or other potentially infectious material such as brain tissue from a rabid animal constitute nonbite exposures. The period of communicability of the rabies virus is in the last 10 days of life a little longer in other wild animals a. In most cases, transmission of the virus is caused by the bite of a rabid animal. Animal bites, non bite exposure, or humantohuman exposure are all ways in which rabies can be transmitted. May 26, 2010 in the united states, the risk of rabies transmission to humans in most situations of possible exposure is unknown. The median risk of rabies transmission without rabies pep for a bite exposure by a skunk, bat, cat. Non bite exposure 1 non bite exposure occurs when saliva or other potentially infectious material comes in contact with mucous membrane without bite. If a potential exposure occurs after hours or on a weekend, call 911. Rabies exposures there were no human rabies cases in 2017. The principal rabies hosts today are wild carnivores and bats, but the virus can also affect pets and other domestic animals. Hi, transmission of rabies virus usually occurs when infected saliva of a host is passed to an uninfected person through a bite. Any penetration of the skin by teeth constitutes a bite exposure.
Monkeys are assessed on a casebycase basis in consultation with the public. In addition, disease control and prevention is promoted by thoroughly reporting all cases to health officials. There is also potential for aerosol transmission however this is only a risk to laboratory workers. An exploratory study on rabies exposure through contact. Primary care physicians must always consider the risk of rabies when treating patients who have had animaltohuman exposures eg, bite, scratch, and if indicated, postexposure prophylaxis must be administered as soon as possible because the infection is fatal once clinical symptoms develop. I have a history of anxiety problems and this is really worrying me. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Rabies pep is considered safe and 100% effective in preventing human rabies following an exposure when administered according to recommendations from. Majority of bites were by stray dogs, categoryiii, exposure to non cases and few received pep. Comparison of a oneweek, 4site regimen versus updated thai red cross regimen in a randomized non inferiority trial in the philippines. Though transmission has been rarely documented via other routes such as contamination of mucous membranes i.
Pdf estimating the risk of rabies transmission to humans in the us. Should i worry about the risk of rabies from indirectnon. My girlfriend called the doctor and he said to come in if i develop a fever, which seems really weird advice. Airborne transmission of rabies has not been documented in homes or any other settings. The other day, i wrote about a case of rabies not associated with a bite. Approximately 6,000 to 7,000 cases of animal rabies are. There was no information collected about bat exposures. Rabies is a viral disease that causes inflammation of the brain in humans and other mammals. An recent article in the journal of clinical virology simani et al 2012 describes six other such cases from iran case 1. Additional information such as location, kind of animal and medical history of patient. Rabies encephalitis is a rapidly progressive cns infection resulting from infection by a member of an rna virus of the family rhabdoviridae, genus lyssavirus, most commonly transmitted to humans, from infected animal vectors, via a bite.
Standard operating procedures rabies protection program. Controlled studies on rabies are clearly not possible. The median estimated risk after possible nonbite exposure to a dog. Intradermal post exposure rabies vaccination with purified vero cell rabies vaccine. For nonbite exposures, there is potential for transmission if an infectious material such as saliva enters the eyes, nose, mouth, or wound of a person. Animal bitepossible human exposure to rabies supplemental. Nonbite exposure introduction of saliva or brainnervous tissue or tears from. The species of the animal and its health may also help determine rabies risk. Rabies risk assessment steps, management of bite wounds nc. A veterinary technician was infected through contact of broken skin with saliva. Approach to management of suspected rabies exposures. The virus that causes it is typically transmitted through the bite of a rabid animal.
However, nonbite exposure such as scratches or contact with mucous membrane warrants further evaluation also. Rabies through non bite exposure tips and tricks from doctors. Four of the non bite exposures had no recognized exposure whatsoever 0. Human cases due to nonbite exposures to rabies are very rare. Inhalation of aerosolized rabies virus is also a potential non bite route of exposure, but other than laboratory workers and spelunkers, most people are unlikely to encounter an aerosol of rabies virus. Pep should be considered in the event of the introduction of fresh saliva andor neural tissue from a known or suspected rabid animal into an open wound, fresh scratch or abrasion, or mucous membrane. The usual regimen consists of 4 vaccines over a 14 day period and an immediate administration of rabies immune globulin.
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